Thursday, November 3, 2016

On Armstrong and Getty with a Diagnosis and Prognosis on Obamacare

Total Obamacare price tag is still around $1.75 T - will be larger if the law is to survive.

When we last spoke in mid-August I told you employer plans were up 7% while Obamacare plans were up 18% to 23%. Well the final results are in and it is the higher end of my projection. 23 to 25% for most Exchange plans in 2017.

Obamacare enrollees are 22% more costly than people covered through employer plans.

Medicaid expansion enrollees are 50% more expensive than originally projected.

2) How Many Are Covered?

We really don’t know. The CBO, Gallup, CDC and Census Bureau all ask different questions and come up with different answers. Even Covered CA simply takes the number of policies sold and multiplies by 1.7 for their “estimate.”

1. Are you uninsured right now?
2. Have you been uninsured for all of the last year?
3. Have you been uninsured at any point in the last year?

We are likely somewhere north of 10 million now but probably well less than 20 million total – and that includes the folks who have gained coverage due to the Medicaid expansion. CBO projects that 9 million were covered under Exchanges in 2016 (up from 8M in 2015).

4) What needs to be done for a Governmental System like this to work? There are only two options to make Obamacare work at this point:

Turn on a firehose of money by increasing the individual and Employer Mandates by about three times and doubling subsidies to all entrants thereby running up another Trillion and an half dollars in costs. Or

Push to a centralized single-payer, Medicare for all type of system and force all of our healthcare workers to be paid substantially less – like European healthcare workers.

Both of these are politically impossible, especially in our current climate.

In 2015 the Gov. Accountability Office conducted an audit of Obamacare Exchange safeguards by creating 18 fictitious applicants and applying for Obamacare with fake Social Securities (some starting with 000) or wholly fictitious people, created from thin air. 17 of 18 of them skated through with coverage.

Of course, HHS and the Exchanges said they’d do better in 2016. They didn’t. This year 16 of 16 made it through. This year GAO was able to befuddle Obamacare with expired IDs, partial documentation and fake people.